“OMM Workshop - Osteopathic Approach to Pediatrics: OM for Otitis Media
Donna Mueller, D.O.
Donna Mueller, DO, MS
PCOM Neuromusculoskeletal Medicine Resident
OSTEOPATHIC APPROACH TO PEDIATRICS
OMT FOR OTITIS MEDIA
OTITS MEDIA

OM is inflammation of the middle ear, may
occur with or without effusion.
RECURRENT OTITIS MEDIA (OM)
Chronic OM & recurrent OM are two most frequent illnesses of
early childhood.
 Common in most cases is Eustachian tube dysfunction.

POMA 107th Annual Clinical Assembly
April 29 – May 2, 2015
1
“OMM Workshop - Osteopathic Approach to Pediatrics: OM for Otitis Media
Donna Mueller, D.O.
WHY AN OSTEOPATHIC APPROACH?

“As the twig is bent, so grows the tree.”
–Alexander Pope
DIFFERENCES B/W ADULTS & CHILDREN
OM STUDY

Pts 6 months to 6 years old w/3 episodes of AOM in past 6
months or 4 in past year (not already surgical candidates) were
given random assignation to routine Peds care (control), or
routine care + OMT (intervention).
POMA 107th Annual Clinical Assembly
April 29 – May 2, 2015
2
“OMM Workshop - Osteopathic Approach to Pediatrics: OM for Otitis Media
Donna Mueller, D.O.
OMT FOR AOM STUDY

Outcome measures were:
 frequency
of AOM,
 antibiotic use,
 surgical
intervention,
behaviors (ear pulling),
 tympanometric and audiometric performance (measured by
audiologist).
 various
OM STUDY
Results – 57 patients (25 intervention, 32 control) completed
study.
 Intervention patients had fewer episodes of AOM and, hence,
fewer surgical procedures.
 Baseline and final tympanograms obtained by the audiologist
showed an increased frequency of more normal tympanogram
types in the intervention group.

OM STUDY
Results – 57 patients (25 intervention, 32 control) completed
study.
 Intervention patients had fewer episodes of AOM and, hence,
fewer surgical procedures.
 Baseline and final tympanograms obtained by the audiologist
showed an increased frequency of more normal tympanogram
types in the intervention group.

POMA 107th Annual Clinical Assembly
April 29 – May 2, 2015
3
“OMM Workshop - Osteopathic Approach to Pediatrics: OM for Otitis Media
Donna Mueller, D.O.
AOM STUDY CONCLUSION
Potential benefit of OMT as adjuvant therapy in children with
recurrent AOM.
 OMT may prevent or decrease the use of antibiotics or surgical
interventions.

OMT FOR OM

Open the thoracic outlet – first rib B/L;

Rib-raising seated;

Anterior and posterior Lymph Node drainage.

Galbreath to open the eustachian tube – B/L;

Trigeminal stim, particularly of Mentalis very important for the
vestibulocochlear nerve.




seated technique w/MFR.
Place children’s hands on your shoulder.
Single side anteriorly, double may be posterior.
facial “raking” (effleurage) in combination.
PROCEDURE CODES FOR OMT
Use 25 modifier in conjunction for “Regions Treated”:
98925 OMT 1-2 regions
98926 OMT 3-4 regions
98927 OMT 5-6 regions
98928 OMT 7-8 regions
98929 OMT 9-10 regions

POMA 107th Annual Clinical Assembly
April 29 – May 2, 2015
4
“OMM Workshop - Osteopathic Approach to Pediatrics: OM for Otitis Media
Donna Mueller, D.O.
SOMATIC DYSFUNCTION CODES
739.0 Head
739.1 Cervical
 739.2 Thoracic
 739.3 Lumbar
 739.4 Sacral
 739.5 Pelvic
 739.6 Lower Ext
 739.7 Upper Ext
 739.8 Ribs
 739.9 Other/Abdomen


CONCLUSION

OMT can improve the quality of life for children:
 Decreased
surgical interventions
use of antibiotics
 Improved tympanogram results
 Decreased

One can teach these OMT techniques to parents/caregivers.
REFERENCES
Carreiro, Jane. An Osteopathic Approach to Children. Elsevier,
2009.
 Mills, et. al. Use of osteopathic manipulative treatment as
adjuvant therapy in children with recurrent otitis media. Arch
Pediatr Adolesc Med; Vol. 157, Sept 2003, pp. 861-866.
 Nelson’s Textbook of Pediatrics, 19th edition. Elsevier, 2011.

POMA 107th Annual Clinical Assembly
April 29 – May 2, 2015
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